Conchal Cartilage Harvest (Anterior Approach)

The Problem

A predictable source of autogenous graft is commonly needed in almost all revision rhinoplasties and many complicated primary nose surgeries.

The Background

Autogenous cartilage is currently the gold-standard augmentation material in rhinoplasty. Different sources of autogenous grafts are frequently compared in rhinoplasty literature, and it seems all sources have their own advantages and limitations.

Conchal cartilage was originally used for minor deformities. However, many new applications have been gradually developed. Hage used conchal cartilage to reinforce alar cartilage; this early work and many other subsequent modifications established the conchal cartilage as an ideal graft to be used in the lower third of the nose. For a long time, the inherent anatomic contour of conchal cartilage was viewed as a major limitation of its use in the nasal dorsum, though many recent works have shown that further preparation of conchal cartilage by crushing, dicing, or cross hatching may provide an acceptable option in dorsal augmentation.

An anterior approach to conchal cartilage gives simple access to the conchal bowl and provides a fair amount of high-quality cartilage. When basic principles are considered, this technique has a low complication rate.